Delaware's harsh flu season forces local hospitals to adapt

Within a large volume of flu cases flooding the emergency room at Saint Francis Hospital, measures to combat the spread of the virus has increased to protect patients and staff.
Jennifer Corbett/The News Journal

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A patient checks in for treatment at St. Francis Hospital's emergency room.(Photo: Jennifer Corbett, The News Journal)Buy Photo

It was a little past 9:30 a.m. on Wednesday and all was quiet at Saint Francis Hospital's emergency department.

On this cold, sleety morning, the hospital beds were empty, the waiting room seats were mostly unoccupied and the majority of the noises were from the low murmurs of nurses chatting.

It was the calm before the storm, the staff said. Just give it an hour or two and patients will be flooding in, complaining of fevers, aches, and diarrhea. They always do — especially this winter, they said.

Like at Saint Francis, emergency rooms are often on the front lines of flu season. But as Delaware and the country faces one of the worst flu seasons in recent years — with cases "skyrocketing" and the death tally increasing — hospitals are taking extra measures to combat the flu.

"I'm going to tell you straight away: This is one of the worst flu seasons, and this will be my 24th year doing emergency medicine," said Dr. Sandy Gibney, an emergency room physician at Saint Francis.

The total number of confirmed flu cases has risen to 1,950 cases as of Jan. 27, state health officials said. They believe the number of actual flu cases is significantly higher because the vast majority of people are not tested. The week of Jan. 21 had the highest number of one-week diagnoses so far with 650 cases, surpassing last year's record of 571.

And four Delawareans, all of whom had underlying conditions, have died from the flu this season.

The number of flu-related hospitalizations in Delaware has also doubled, going from 158 this time last year to 398 so far this season.

Flu prevention stations are placed around the emergency room at St. Francis Hospital to prevent the spread of the virus. (Photo: Jennifer Corbett, The News Journal)

Saint Francis has started to "pre-triage" people as soon as they walk into the ER's waiting room, Gibney said. Stations filled face masks and hand sanitizer are sprinkled around the hospital, including in the waiting room. If a patient shows potential flu-like symptoms, such as body aches or a fever, they'll be put in an isolated waiting room to avoid potentially spreading the illness.

And like many hospitals, Saint Francis has increased the number of staff on each shift. Gibney estimates that staff volume is currently 15 to 20 percent higher than the non-flu season.

This year, the hospital has a large crate filled with flu swabs, she said. Previously, there would typically be about a dozen kits in a drawer at a given time. Saint Francis also relied on the SteraMist, an $18,000 machine that helps disinfect the patient rooms, this flu season.

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Dr. Sandy Gibney, head of emergency for St. Francis Hospital, demonstrates the SteraMist machine that is used killed flu virus in hard to reach places in the hospital. (Photo: Jennifer Corbett, The News Journal)

The machine sprays a mist through an object that resembles the "Ghostbusters" proton wand. It can kill millions of viral particles that lurk on curtains and under hospital beds in about seven minutes, Gibney said.

The hospital bought the SteraMist when it prepared for potential Ebola cases in 2015. This is the first year the hospital is using it during flu season. While the staff still cleans the rooms with disinfectant wipes, this adds extra precaution, Gibney said.

Delaware doctors and nurses also have had to be judicious about certain medical supplies to avoid any shortages, which has been the case for some hospitals across the country.

Saint Francis' emergency department hasn't yet run out of flu kits or medicine such as Tamiflu, which has been the case in previous years, she said. Hospital staff used to be generous in terms of who it gave Tamiflu to and how much they received.

Now, the hospital is only giving the medicine to people who have tested positive for the flu, Gibney said.

And unlike previous years, Delaware hospitals are being more conservative about which patients receive intravenous fluid bags. Hospitals in the United States are currently facing a shortage of IV bags because many are made in Puerto Rico.

Puerto Rico is still recovering from Hurricane Maria in October, and power outages have prevented the manufacturing and exporting of pharmaceutical goods and medicine.

Gibney said Saint Francis is giving patients a half liter of fluids, opposed to automatically starting at a liter, and then increasing it as necessary.

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Extra linens are on hand in the emergency room at St. Francis Hospital for the influx of flu patients that are coming in for treatment. (Photo: Jennifer Corbett, The News Journal)

So far this season, Wysocki said she's seen far more pediatric patients than usual. State health officials said Delaware children have made up about 25 percent of the season's cases. No child has died in Delaware but Maryland announced on Tuesday the first death of a child from the flu. In Pennsylvania, 91 people have died from the flu, two of them under the age of 18.

To keep the illness from spreading, local hospitals are asking people to not visit patients.

At Bayhealth, patients are being asked to refrain from bringing children 16 or younger to visit as an extra level of precaution for both patients and visitors, spokeswoman Danielle Pro-Hudson said.

At Saint Francis, only patients with influenza are being asked to limit visitors, Gibney said. The few who are given permission to visit must wear a full isolation gown, mask, and gloves, she said.

Federal and state officials are pushing flu shots more urgently than ever because the CDC is concerned about a strain of the flu that has caused a huge number of illnesses and deaths in Australia. Experts say it's not too late to get the flu shot.

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Surgical mask are placed around the emergency room at St. Francis Hospital to prevent the spread of the virus. (Photo: Jennifer Corbett, The News Journal)

Because of the uptick in cases, hospitals in other states have pitched surge tents outside of their facilities in order to keep up with the number of people coming in with flu-like symptoms.

Delaware doctors say they haven't had found it necessary to set up tents and aren't sure if it will ever be needed.

Dr. Marci Drees, infection prevention officer and hospital epidemiologist for Christiana Care Health System, said the hospital prefers to not use tents in a situation like flu season. Once people are outside of the hospital's walls, it becomes trickier to treat them, she said.

Drees said Christiana Care, like the other hospital systems, also has been busy in recent weeks but hasn't had to change too much of its protocol, other than increasing on-call staff when necessary.

"Hopefully, it will be peaking soon," she said.

Contact Meredith Newman at (302) 324-2386 or at mnewman@delawareonline.com. Follow her on Twitter at @merenewman.